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Antimicrobial Agents and Chemotherapy, February 1998, p. 269-276, Vol. 42, No. 2
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

A Rapid Method for Simultaneous Detection of Phenotypic Resistance to Inhibitors of Protease and Reverse Transcriptase in Recombinant Human Immunodeficiency Virus Type 1 Isolates from Patients Treated with Antiretroviral Drugs

Kurt Hertogs,1,* Marie-Pierre de Béthune,2 Veronica Miller,3 Tania Ivens,2 Patricia Schel,1 Anja Van Cauwenberge,1 Christel Van den Eynde,1 Veerle van Gerwen,1 Hilde Azijn,2 Margriet van Houtte,1 Frank Peeters,1 Schlomo Staszewski,3 Marcus Conant,4 Stuart Bloor,5 Sharon Kemp,5 Brendan Larder,5 and Rudi Pauwels1,2

VIRCO, Central Virological Laboratory,1 and TIBOTEC, Institute for Antiviral Research,2 B-2650 Edegem, Belgium; Klinikum der Johann Wolfgang-Göethe Universität, Zentrum der Inneren Medizin, Frankfurt, Germany3; Conant Medical Group, San Francisco, California4; and Glaxo Wellcome Research and Development, Stevenage, United Kingdom5

Received 25 July 1997/Returned for modification 29 September 1997/Accepted 25 November 1997

Combination therapy with protease (PR) and reverse transcriptase (RT) inhibitors can efficiently suppress human immunodeficiency virus (HIV) replication, but the emergence of drug-resistant variants correlates strongly with therapeutic failure. Here we describe a new method for high-throughput analysis of clinical samples that permits the simultaneous detection of HIV type 1 (HIV-1) phenotypic resistance to both RT and PR inhibitors by means of recombinant virus assay technology. HIV-1 RNA is extracted from plasma samples, and a 2.2-kb fragment containing the entire HIV-1 PR- and RT-coding sequence is amplified by nested reverse transcription-PCR. The pool of PR-RT-coding sequences is then cotransfected into CD4+ T lymphocytes (MT4) with the pGEMT3Delta PRT plasmid from which most of the PR (codons 10 to 99) and RT (codons 1 to 482) sequences are deleted. Homologous recombination leads to the generation of chimeric viruses containing PR- and RT-coding sequences derived from HIV-1 RNA in plasma. The susceptibilities of the chimeric viruses to all currently available RT and/or PR inhibitors is determined by an MT4 cell-3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide-based cell viability assay in an automated system that allows high sample throughput. The profile of resistance to all RT and PR inhibitors is displayed graphically in a single PR-RT-Antivirogram. This assay system facilitates the rapid large-scale phenotypic resistance determinations for all RT and PR inhibitors in one standardized assay.


* Corresponding author. Mailing address: VIRCO NV, Central Virological Laboratory, Intercity Business Park, Generaal de Wittelaan 11B4, B-2800 Mechelen, Belgium. Phone: 32 15 286 340. Fax: 32 15 286 346. E-mail: kurt.hertogs{at}virco.be.


Antimicrobial Agents and Chemotherapy, February 1998, p. 269-276, Vol. 42, No. 2
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.



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